Dayna Cooper had no idea her daughter plummeted from an ‘A’ student to an ‘F’ student, let alone why.
After three years of unaddressed bullying and a trip to Cincinnati Children's, her daughter, Sydney, received a diagnosis of anxiety and panic attack disorder. With that diagnosis, Sydney was able to begin seeing a school-based therapist, enabling her mom to better understand how her daughter’s mental health impacted her academic performance.
Had more individualized behavioral health data been available to her, Cooper said she could have helped Sydney with her mental health before it culminated into repeated panic attacks. However, without the trip to Cincinnati Children’s, she fears Sydney would still be on a waitlist to see a therapist, both privately and through St. Bernard-Elmwood Place High School, where she is a sophomore.
"Even a monthly report, such as 'Hey your student Sydney is having this issue,' " Cooper said, on what information — anecdotal or data-specific — would’ve been nice to have.
Cooper is not alone. In the absence of individualized data collection, youth mental health — including severe cases of suicide risk — can go undetected by parents, teachers, and doctors. As suicide has become a leading cause of youth death in recent years, experts say that if more data is collected on youth mental health, the greater chance prevention efforts are successful.
The question is, who is responsible for collecting that data?
What schools are doing
Due to the amount of time youth spend in educational settings, schools have become a hub for public and private efforts to better track and measure youth mental health.
WVXU checked in with area districts — including two of the region’s largest, Cincinnati Public and Forest Hills — and found just a handful are tracking student mental health, including Lakota Local Schools and Milford Public Schools.
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All Ohio schools are required to dedicate one hour per year to suicide awareness and prevention for grades six through 12, after House Bill 123 was signed into law in 2021. One of the six available options for schools to satisfy the state’s requirement is the Signs of Suicide Prevention Program (SOS). The program, which Nationwide Children’s in Columbus helped implement, collects some data on youth suicide risk.
Students at schools that utilize SOS are given an optional seven-question survey that has two suicide-specific questions. Nearly 15% of kids who take the SOS survey report signs of elevated depression or suicide risk, according to John Ackerman, the suicide prevention coordinator for the Center for Suicide Prevention and Research at Nationwide Children’s.
“We always identify a pretty significant number of kids because that’s currently the state of what we’re dealing with,” Ackerman said.
When a questionnaire is put before students asking about their mental health, their willingness to be truthful is an issue complicating the data collected, Ackerman said.
Sydney confirms this, having taken such a survey at her school. But, "You would take this survey about how you feel — it would always be at the beginning of the year — and we would never hear anything about it for the rest of the year," she said, on why at times she hasn’t felt the need to be completely forthcoming.
Although the SOS program has connected nearly 4,000 Ohio students with follow-up care post-survey, the data collected is still optional and relies on students to be truthful.
Emma and Nathan Rutemueller, a senior and freshman at St. Bernard, respectively, are among the students who’ve completed the SOS survey.
“I know as a senior a lot of kids are like, ‘Whatever, school’s almost over, we’re adults,’ and they kind of just push it off,” Emma said.
Nathan and Emma are among the 63 students who meet regularly with two school-based therapists placed in St. Bernard by Greater Cincinnati Behavioral Health Services (GCBHS). The data GCBHS collects on the students it sees is individually based and guides treatment. The data is reported yearly to MindPeace, the Cincinnati-based nonprofit that provided school-based mental health care to nearly 200 schools in the region last year.
MindPeace refers students to mental health care and tracks how many of them — 72% of students during the 2022-2023 school year — actually access services. This is one of the main measures MindPeace tracks because the CDC found in 2023 that nearly 80% of children with mental, emotional, or behavioral disorders receive care from a mental health care provider.
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Although this national measurement is helpful, the state of Ohio does not monitor the local implementation of House Bill 123 and thus doesn’t require complying schools to report back data, according to an Ohio Department of Education and Workforce spokesperson.
“So the state wants all this kind of data and they haven’t learned yet that with the language they use, they’re not going to get the data they want,” Shannon Russell, GCBHS’s director of school-based and Northern Kentucky services said, referencing House Bill 123.
The private sector steps in
Rich Gilman was working on school-based mental health programs as a child and clinical psychologist for Cincinnati Children’s when he saw a void to fill. Disappointed by the way some data collected on children was not used to implement change, Gilman founded Terrace Metrics in 2018 to help schools gauge the mental health of their community, student by student.
“As powerful as health care can be — and is — it doesn’t get to the root of the issue,” Gilman said.
Cincinnati-based Terrace Metrics provides its mental health testing to 12 school districts in Ohio, 60% percent of school districts in Kentucky, and is expanding in Indiana.
Gilman says what allows his resilience-based measuring to work is that it involves parents, measures the mental health of each individual student, and offers personalized reports for the school and parent. Unlike some optional state-level questionnaires, students at schools that opt-in to Terrace Metrics can request to take the test as frequently as they’d like, meaning parents could receive multiple reports a year on their child.
Gilman says these individualized parental reports have helped refer students to care who were at risk of suicide.
An elusive solution
While advocating for a more unified approach to collecting mental health data, Jennifer Wright-Berryman, who is an expert in suicidology at the University of Cincinnati’s School of Social Work, says the responsibility shouldn’t fall solely on schools. In its best form, Wright-Berryman sees a partnership between schools, parents, health care, and the community.
“If we truly want to change the landscape of mental health and suicide in this country, we have to have an upstream effect of both data and intervention — everybody has to be on board,” Wright-Berryman said.
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When a community loses a child to suicide, Wright-Berryman says it is common for the blame to be put on the school. Because of this, subsequent data collection is often expected to be provided by the school, but she says the question hasn’t even been asked of who should conduct local measuring of youth suicide risk.
“We have to figure out a way to get community buy-in because schools should not be the center of all that needs to be done for children,” Wright-Berryman said. “Nobody is going to collect data on a problem they’re not interested in solving, so we need our community to come together and say, ‘This is a problem that we want to solve together.’ ”
If you or someone you know may be considering suicide or is in crisis, call or text 9-8-8 to reach the Suicide & Crisis Lifeline.
